RCN Research Institute
RCN RESEARCH
INSTITUTE
Newsletter
DIRECTOR:
Prof Kate Seers
V O L U M E
OUR RESEARCH
THEMES:
Patient Reported
Outcomes
Brett J, Staniszewska S,
Newburn M, Jones N,
Taylor L. A systematic
mapping review of
effective interventions for
communicating with,
supporting and providing
information to parents of
preterm infants. BMJ
Open 2011;1:e000023
doi:10.1136/bmjopen-2010000023
Translating Knowledge
into Practice
This newsletter presents
selected highlights of our
research. For details of the
full programme please see
our website.
INSIDE THIS
ISSUE:
Emotional Labour
2
HTAi Conference
2
NICE Guideline
2
PhD Student
3
Risk of Falling
3
EASi-QoL
4
http://www2.warwick.
ac.uk/fac/soc/shss/rcn
I S S U E
4
J U L Y / A U G / S E P
2 0 1 1
Parents of Preterm Infants
Patient and Public
Involvement & Patient
Experiences
Website address:
3 ,
This systematic review aimed
to identify and map out
effective interventions for
communication with,
supporting and providing
information for parents of pre
-term infants. The birth of a
pre-term infant can be an
overwhelming experience of
guilt, fear, and helplessness for
parents. Provision of
interventions to support and
engage parents in the care of
their infant may improve
outcomes for both the
parents and the infant.
Studies were included if they
provided parent-reported
outcomes of interventions
relating to information,
communication, and/or
support for parents of preterm infants prior to the birth,
during care at the Neonatal
Intensive Care Unit, and after
going home with their preterm infant. The review
included 72 papers, 19 papers
were randomised controlled
trials, 16 were cohort or quasi
-experimental studies, 37 were
non-intervention studies.
Parents reported feeling
supported through
individualised developmental
and behavioural care
programmes, through being
taught behavioural assessment
scales, and through breast
feeding, kangaroo care and baby
massage programmes. Parents
also felt supported through
organised support groups and
through provision of an
environment where parents can
meet and support each other.
Parental stress may be reduced
through individual
developmental care
programmes, through
psychotherapy, through
interventions that teach
emotional coping skills and
active problem solving, and
journal writing.
The review reports the
importance of preparing
parents for the neonatal
process through the neonatal
tour, and the importance of
good communication
throughout the infant admission
phase and after discharge home.
Providing individual web-based
information about the infant
through web-based
programmes such as babyLink,
recording doctor-patient
consultations, and provision of
timely information collated in
an information binder were
intervention reported to
improve communication with
parents. The review also
reports the importance of
thorough discharge planning
throughout the infant’s
admission phase and the
importance of home support
programmes to provide
continuity of care
This systematic review was
part of the POPPY project
which was a three year
research project to identify
effective interventions for
communication, information
and support for parents of
premature infants funded by
the Big Lottery. The research
was conducted in
collaboration with the
National Childbirth Trust,
Bliss – The Premature Baby
charity, and the National
Perinatal Epidemiology Unit
(NPEU)
Website: http://www.poppyproject.org.uk/
The work of the RCNRI aims
to:
► Produce high quality
research that improves patient
care and impacts on policy
► Increase research capacity
within nursing by providing high
quality research training
► Contribute towards the
RCN delivering on its strategic
objectives
Contact: Kate Seers
PAGE
2
Emotional Labour
An increasing focus
on the value and
understanding of
emotional labour
within team
structures is
required.
Liz Tutton and Debbie
Langstaff (Matron, Oxford
Trauma Unit) ran two
workshops on Emotional
Labour at the Front Line
First Conference on July
18th at RCN HQ. The workshop drew on the work of
Arlie Hochschild who
identified emotional labour
as the induction or
suppression of feeling to
produce a emotional state in
others such as, being
comforted or cared for.
Research on Comfort,
Trauma and Hope were used
to illustrate aspects of
emotional labour and insights
from key authors such as Pam
Smith, Helen Allan and Billie
Hunter were identified. In
addition Debbie provided a
stimulating overview of
emotion labour in daily life on
a Trauma Unit. There was a
high level of engagement in the
topic and three areas of
concern were identified: new
managerialism detracting from
humanistic approaches to care,
a need for an increasing focus
on shared beliefs and values
regarding the nature of
nursing, and an increasing
focus on the value and
understanding of emotional
labour within team structures.
Contact: Liz Tutton
HTAi Conference
HTAi Annual
Conference in Rio
Sophie Staniszewska
attended the Health
Technology Assessment
International (HTAi) Annual
Conference in June 2011,
which took place in Rio de
Janeiro, Brazil. This was the
8th HTAi conference and
representatives from over 50
countries attended. The
conference provided an
important forum for
researchers, health
professionals and managers
to share experiences and
knowledge on the best HTA
practices for decision
making. Sophie presented a
poster on the GRIPP checklist,
the first international checklist
to provide guidance for
researchers on what key
information they need to
report when undertaking
patient and public involvement.
Sophie also presented a paper
as part of a panel session on
strengthening the voice of
patient and the public in health
technology assessment,
through closer collaborative
working of patients with
researchers in the
development of patient
reported outcome measures.
Staniszewska S, Brett J,
Mockford C, Barber R (2011).
The GRIPP checklist:
Strengthening the quality and
transparency of reporting for
patient and public involvement
in research. International
Journal of Technology
Assessment for Health Care,
In press.
Contact: Sophie
Staniszewska
NICE Guideline
The National Institute for
Health and Clinical Excellence
(NICE) produces clinical
guidelines, quality standards,
public health and health
technology appraisal guidance
for the National Health
Services in England, Wales and
Northern Ireland. The
National Clinical Guideline
Centre ( NCGC), based at the
Royal College of Physicians,
RCN
RESEARCH
INSTITUTE
commissioned a scoping study
to be undertaken by the Royal
College of Nursing Research
Institute at the University of
Warwick, led by Sophie
Staniszewska, which developed
the Warwick Patient
Experiences Framework
(WaPEF). The WaPEF
Framework influenced the
development of the NICE
Guidance, which Sophie
Staniszewska subsequently
chaired. The NICE guideline
and quality standards entitled
‘Patient experience in adult
NHS services: improving the
experience of care for people
using adult NHS services will
be released on 14 October
2011.
Contact: Sophie
Staniszewska.
VOLUME
3,
ISSUE
PAGE
4
3
PhD Student: Mayada Daibes
My PhD is one of the most exciting
and positive experience in my life. I
started studying for a PhD at the
RCN Research Institute in 2008, and
now, I am in my third year.
was not a straightforward process, it
was exciting, I could contact people
and see their different experiences
directly, not only through research
papers.
At the beginning it was important to
carry out a literature review, which
revealed that despite well
established advances in pain
management, many patients still
experience pain of high intensity
postoperatively.
Findings of the research suggest that
intertwined contextual factors have
a profound effect on less effective
pain management and there is a
limited application of evidence-based
advances in Jordanian hospitals.
My aim was particularly to examine
factors which influence staff and
patients’ practices and interactions
in the pain management process.
Therefore, a qualitative case study
was designed and fieldwork was
conducted for eight months in
Jordan. Although data collection
With the commitment and guidance
of my supervisors, I could finish my
PhD in less than three years and I
submitted my thesis in July, 2011.
The support presented from my
school and the graduate school
intensively enriched my personal and
professional development, and I am
looking forwards using all the skills I
have gained to benefit nursing
education and practice in Jordan.
Contact: Kate Seers
The RCN Research Institute,
within the School of Health
and Social Studies, at the
University of Warwick,
provides a vibrant student
research community. If you
are interested in undertaking
a PhD, part time or full time,
please contact:
Prof Kate Seers.
Risk of Falling: Older people’s views
McInnes, E. Seers, K. Tutton, L.
Older people’s views in relation
to risk of falling and need for
intervention: a metaethnography. Journal of
Advanced Nursing. Doi:1111/
j.1365-2648.2011.05707.x
This study explored older people’s
views regarding the risk of falling
and need for intervention. Eleven
studies were identified as relevant
and of a good standard. These
studies were examined using metaethnography to explore similarities
and differences. Synthesis of the
studies revealed six core concepts;
beyond personal control,
rationalizing salience, life change and
identity, taking control and selfmanagement.
Falls were often seen as something
that just happened and were not
within individual’s control; a way of
maintaining a view of the self as
independent and competent.
Often risk was rationalised away as
something for the future not the
here and now. Salient risk was
linked to frailty and the need to be
cared for, which individuals
rejected. A sense of control could
be obtained through self
management strategies and
choosing to live with a degree of
risk.
Healthcare professional tended to
focus on physical risks whereas
individuals focused on lifestyle and
identity. Acceptance of
interventions therefore affecting
their daily life and perceptions of
themselves as old and frail. Self
management strategies were
considered empowering and
included ways of approaching life,
such as not giving up, taking it easy,
and being cautious.
The limitations of the approach
taken are identified and the
benefits of providing new
understanding through synthesis
across studies. Implications for
practice identify the importance of
developing good working
relationships based on trust,
understanding older people's views
of risk and the effect it has on their
life, including preferences for self
management and control.
Contact: Liz Tutton
RCN
RESEARCH
INSTITUTE
PAGE
4
EASi-QoL
A successful collaboration between
the RCNRI, the Arthritis Research
UK Primary Care Centre at Keele
University, and the National Centre
for Rheumatology in Norway, led by
Dr Kirstie Haywood, Senior
Research Fellow (Patient Reported
Outcomes) at the RCNRI has
resulted in the development of an
important new patient reported
outcome measure (PROM) for the
assessment of Ankylosing Spondylitis
(AS)-specific quality of life: the
Evaluation of AS-specific Quality of
Life questionnaire (EASi-QoL)[1].
drug therapy (Etanercept 50mg
weekly or Sulfasalazine 3g daily)[2].
Initial evidence of the minimal
important change (MIC) in score,
following improvement in selfreported AS-specific health, is also
provided. Evidence suggests that the
EASi-QoL has greater or similar
levels of responsiveness in both
observational and trial situations
compared to commonly used
measures. When combined with
earlier evidence in support of
measurement reliability, validity and
acceptability, these results suggest
that the EASi-QoL should be
considered for further application in
the assessment of patients in both
routine practice and research
settings.
A recent publication details evidence
of comparative responsiveness
following postal completion by a UK
-wide patient cohort, and following
completion in a randomised trial of
Further information about the EASiQoL and other AS-related work can
be obtained by contacting Dr Kirstie
Haywood
(k.l.haywood@warwick.ac.uk).
EASi-QoL: responsiveness of a
new Patient Reported Outcome
Measure
References:
1. Haywood KL, Garratt AM, Jordan
KP, Healey EL, Packham JC. (2010)
Evaluation of Ankylosing Spondylitis
Quality of Life (EASi-QoL): reliability
and validity of a new patient-reported
outcome measure. The Journal of
Rheumatology. Oct;37(10):2100-9.
Epub 2010 Aug 3.
2. Packham JC, Jordan KP, Haywood
KL, Garratt AM, Healey EL. (2011)
Evaluation of Ankylosing Spondylitis
Quality of Life (EASi-QoL):
Responsiveness of a new Patient
Reported Outcome Measure.
Rheumatology (Oxford) in press
RCN Research Institute
School of Health and Social Studies
University of Warwick
COVENTRY
CV4 7AL
RCNRI Staff Email Contacts:
j.brett@warwick.ac.uk
l.gunn@warwick.ac.uk
k.I.haywood@warwick.ac.uk
Website Address:
www2.warwick.ac.uk/fac/soc/shss/rcn
d.r.kennedy@warwick.ac.uk
RCNRI Research Team Administrator:
carole.mockford@warwick.ac.uk
Paul Kent
c.e.new@warwick.ac.uk
Phone: 024 761 50618
Fax:
024 761 50643
email: p.d.kent@warwick.ac.uk
kate.seers@warwick.ac.uk
sophie.staniszewska@warwick.ac.uk
liz.tutton@warwick.ac.uk